Brandon Equine Medical Center’s medicine section prides itself on individualized and pragmatic care for every patient we work with. The availability of diagnostic tools such as digital radiography and ultrasound, endoscopy, and an in-house laboratory, in combination with the expertise of our clinicians doing advance procedures, makes us well equipped to handle a wide variety of complex medical conditions.

Many people inquire about the different cases that internal medicine specialists (often called “internists”) have experience treating and consulting on. These can include, but are not limited to:

Equine Asthma (RAO/Heaves, Inflammatory Airway Disease)

One of the most common causes of poor performance in the horse is a condition that has been recently re-classified as Equine Asthma Syndrome. This disease is used to describe the continuum along which inflammatory airway disease (IAD) and recurrent airway obstruction (RAO/heaves) fall, where mild respiratory disease progresses over time to overt respiratory embarrassment and distress. Clinical signs initially include occasional cough, mild exercise intolerance, and mucous expectoration, with severe exercise intolerance, frequent coughing, respiratory effort at rest, and even overt distress developing later in life. A thorough clinical assessment, and tools such as upper and lower airway endoscopy, and bronchoalveolar lavage (BAL) allow us to diagnose these problems, and develop individualized treatment plans for each case.

Infectious Respiratory Disease

Even under the best of circumstances, all horses that travel and show are at some risk of developing respiratory disease, including viral and bacterial upper respiratory tract infections, and bacterial broncho- or pleuropneumonia (“shipping fever”). Under some circumstances, these conditions can cause serious illness if not treated aggressively, and can increase the risk of permanent respiratory tract damage and devastating sequelae like laminitis. Our intensive care and isolation facilities, and dedicated clinicians and technicians, are available 24-hours a day for routine and emergency treatment of these conditions.

Chronic Colic/Diarrhea and Inflammatory Bowel Disease

Chronic colic can be a diagnostic puzzle, which is frustrating for owner and veterinarian alike. BEMC is well equipped with both a team of specialists, and the necessary diagnostic equipment (digital ultrasound and radiographs, gastroscopy, proctoscopy) to help diagnose your horse’s gastrointestinal dilemmas and formulate a personalized treatment protocol.

Infectious Diarrhea

Not unlike infectious respiratory disease, infectious diarrhea can be a devastating and life-threatening condition if not managed aggressively. Our medicine service is well equipped to not only diagnose and isolate these conditions, but provide intensive, advanced-level care to affected horses. Knowing that in these cases often there is more than one horse affected, education about biosecurity and whole-farm management is also available.

Neurologic Disease

Neurologic conditions are complex to diagnose, and often require prolonged treatment with specialized management in order to achieve a good outcome. Our medicine service not only has the ability to localize your horse’s problem, but also has comfort with the advanced procedures and tools necessary to help reach a diagnosis [cerebrospinal fluid centesis (CSF tap), myelogram, digital radiography, etc.]

Nutritional Consultations

Nutrition is a critically important contributor to the health of our four-legged companions, but is an often-confusing topic about which many people have differing opinions. Brandon Equine is proud to offer comprehensive nutritional consultations with our board certified internal medicine specialist, which can not only help formulate a complete and balanced diet for your equine athlete or companion, but also help develop nutritional plans for horses with special nutritional needs, such as those with metabolic syndrome, PPID, HYPP, and PSSM, among many others. Nutritional consultations begin an in depth discussion of your horse’s diet, lifestyle, and use, as well as any specific concerns you have, followed by a detailed breakdown of how the current diet meets the needs of your horse. Based on this evaluation, changes to the concentrate and forage rations can be recommended. 

High-Risk Pregnancy, Neonatology, and Foal Wellness

While we hope no one ever experiences the heartbreak of a sick broodmare or foal, illness can sometimes develop despite our best efforts. Our medicine team is not only available to help assess the health and wellness of your high-risk mare or neonatal foal soon after birth, but are also there to help when things do not go as planned. We are available for management of high-risk pregnancies, dystocias, and post-foaling complications, and the doctors and technicians in our neonatal intensive care unit (NICU) are capable of handling nearly every complication your foal might experience, including sepsis, pneumonia, joint and bone infections, colic, neonatal encephalopathy (“dummy foal” syndrome).

Endocrine Disease (Equine Metabolic Syndrome, Cushing’s Disease) and Laminitis

Metabolic disorders are among the most common conditions seen in horses, especially those considered to be geriatric (>20 YO). Pituitary pars intermedia dysfunction (PPID; Equine Cushing’s disease) and Equine metabolic syndrome (EMS) are common conditions which are best recognized and managed early, before life threatening complications (laminitis) develop. Our medicine service has extensive experience diagnosing and managing these complicated conditions, as well as their sequelae and are available for both primary evaluations, as well as consultations, to help maximize your equine companion’s quality of life well into their golden years.

For help deciding if your horse is at risk of PPID or EMS, visit to learn more about the symptoms and diagnosis of these conditions.

Geriatric Health and Wellness

Email Dr. Melissa Resitfo at for information.

Renal and Urinary Tract Disease

Excessive drinking and urination, bloody urine, colic, and lack of urine production can all be signs of renal (kidney) disease. These conditions can develop both chronically and acutely, for numerous reasons, including infectious conditions, toxin exposure, neoplasia, degenerative conditions, and drug toxicities. If you have questions about the health of your horse’s urinary tract, our specialists are available for consultations and assessments on both an emergency and appointment basis.

Liver Disease

While uncommon, acute liver injury can be devastating, and end with life-long consequences in our equine patients. Routine and advanced hematology, digital ultrasound, and liver biopsy are just a few of the tools our specialists offer in order to help diagnose the underlying cause of this complex problem. Liver disease can develop due to toxin exposure, bacterial or viral infections, and gastrointestinal disease, among others, and horses often exhibit non-descript signs such as lethargy, inappetence, mild colic, and jaundice. Our medicine service is available for both consultations and primary assessments of horses suspected to be suffering from liver dysfunction.

Cardiac Disease

Email Dr. Melissa Resitfo at for information.

Anemia or Bleeding Disorders

Email Dr. Melissa Resitfo at for information.

Poor Performance and Muscle Conditions

Poor performance can develop for a number of reasons, and at BEMC we often take a team approach between our medicine and surgery specialists to localize the underlying problem. While orthopedic problems are a common cause, Equine asthma syndrome (see above) and muscle conditions are among the more common causes of poor performance for which a medicine specialist is a valuable asset to the team. Conditions such as HYPP (hyperkalemic periodic paralysis), Polysaccharide storage myopathy (PSSM) types 1 and 2, malignant hyperthermia, as well as several other neuromuscular diseases can be difficult to diagnose and complicated to manage. Our specialists are available to help diagnose these conditions, as well as formulate diet, lifestyle, and exercise recommendations to help manage these complex diseases.

Neoplasia (Cancer)

Email Dr. Melissa Resitfo at for information.